Body Composition-Specific Asthma Phenotypes: Clinical Implications.
Body Composition-Specific Asthma Phenotypes: Clinical Implications.
复制标题
身体成分特异性哮喘表型：临床意义
作者：
背景：以往的研究表明，身体质量指数定义疾病表型的局限性。基于身体组成（BC）的哮喘表型的描述还没有大量报道。目的：基于BC参数识别和表征哮喘患者的表型。研究方法：进行了一项包含两个前瞻性观察队列的研究，分析了稳定型哮喘成人患者（培训n = 541，验证n = 179）。对纳入的患者进行身体成分分析。聚类分析采用两步逐步判别分析法。Logistic回归模型用于评估确定的表型和哮喘急性发作（AE）之间的关联。使用独立验证组中聚类分析的相同算法进行外部验证。结果：三个聚类具有与哮喘结局相关的显著不同的特征。外部验证确定了训练和验证集的参与者的相似性。在训练集中，聚类训练（T）1（29.4%）是“营养不良的患者”，聚类T2（18.9%）是“具有心理功能障碍的中等营养水平”，聚类T3（51.8%）是“营养良好的患者”。与其他两个聚类相比，聚类T3在次年中重度和重度AE的风险降低。有助于准确分配到这三个集群之一的最重要的BC特定因素是骨骼肌质量和内脏脂肪面积。结论：我们定义了三个不同的哮喘患者群，它们具有不同的临床特征和哮喘结局。我们的数据加强了在临床实践中评估BC以确定营养状况的重要性。
Background: Previous studies have indicated the limitations of body mass index for defining disease phenotypes. The description of asthma phenotypes based on body composition (BC) has not been largely reported. Objective: To identify and characterize phenotypes based on BC parameters in patients with asthma. Methods: A study with two prospective observational cohorts analyzing adult patients with stable asthma (n = 541 for training and n = 179 for validation) was conducted. A body composition analysis was performed for the included patients. A cluster analysis was conducted by applying a 2-step process with stepwise discriminant analysis. Logistic regression models were used to evaluate the association between identified phenotypes and asthma exacerbations (AEs). The same algorithm for cluster analysis in the independent validation set was used to perform an external validation. Results: Three clusters had significantly different characteristics associated with asthma outcomes. An external validation identified the similarity of the participants in training and the validation set. In the training set, cluster Training (T) 1 (29.4%) was “patients with undernutrition”, cluster T2 (18.9%) was “intermediate level of nutrition with psychological dysfunction”, and cluster T3 (51.8%) was “patients with good nutrition”. Cluster T3 had a decreased risk of moderate-to-severe and severe AEs in the following year compared with the other two clusters. The most important BC-specific factors contributing to being accurately assigned to one of these three clusters were skeletal muscle mass and visceral fat area. Conclusion: We defined three distinct clusters of asthma patients, which had distinct clinical features and asthma outcomes. Our data reinforced the importance of evaluating BC to determining nutritional status in clinical practice.
DOI：
10.1111/cea.12306
发表时间：
2014
期刊：
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
影响因子：
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作者：
Kurukulaaratchy RJ;Zhang H;Raza A;Patil V;Karmaus W;Ewart S;Arshad SH
通讯作者：
Arshad SH